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Sormin, Delores Elisabeth, Parluhutan Siagian, Bintang YM Sinaga, and Putri Chairani Eyanoer. "Neutrophyl Lymphocyte Ratio in Tuberculosis Patients and Multi Drug Resistant Tuberculosis Patients." Jurnal Respirologi Indonesia 38, no. 3 (September 17, 2018): 177–80. http://dx.doi.org/10.36497/jri.v38i3.8.
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Background: Delayed in diagnosis and treatment of tuberculosis will increase the risk of MDR TB. WHO recommends Xpert MTB/RIF as
diagnostic tools to identify MDR TB. Availability of Xpert MTB/RIF is still limited, another diagnostic tool is needed. Neutrophyl lymphocyte
ratio (NLR) was presumed to be able to identify the probability of MDR TB. The aim of this study is to evaluate the comparison of NLR in tuberculosis
and MDR TB patients.
Methods: This is an analytic descriptive study with case series approach in Adam Malik General Hospital Medan. This study held since
January – December 2015 with number of sample as much as 100 bacteriological confirmed TB patients and 100 MDR TB patients. We
performed leukocyte differential count from peripheral blood examination to obtain NLR
Result: Mean NLR of TB patient 4.62±2.37 and MDR TB 3.28±1.44. There was significant difference of NLR between both groups using
Mann-Whitney test (P=0.001). The cut off value by ROC analysis was 2.91 with sensitivity, specificity, positive predictive value, negative
predictive value and accuracy was 77%, 50%, 60.6%, 68.4% and 63.5% respectively.
Conclusion: There was significant difference of NLR between bacteriological confirmed TB patients and MDR TB patients. Value of NLR
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Widiastuti, Erma Nurjanah, Yanri Wijayanti Subronto, and Dibyo Promono. "Faktor risiko kejadian multi drug resistant tuberculosis di RSUP Dr. Sardjito." Berita Kedokteran Masyarakat 33, no. 7 (July 1, 2017): 325. http://dx.doi.org/10.22146/bkm.18290.
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PurposeThe purpose of this study was to identify the determinants of multidrug resistant events in patients with tuberculosis in Dr. Sardjito Hospital in Yogyakarta.MethodsA cross-sectional study was conducted involving 122 patients with suspected MDR TB consisting of 61 cases of MDR TB and 61 non MDR TB cases. The data collected were secondary data from MDR TB.06 registers, medical records, MDR TB.03 registers, and MDR TB patients' baseline data forms at Dr. Sardjito Hospital Yogyakarta from January 2012 until September 2016. Data were analyzed to determine the correlation between independent variables and dependent variable using Chi-Square tests, and to know the most dominant risk factors using multiple logistic regression tests.Results MDR TB patients’ characteristics showed there were more males (63.93%), age >45 years (52.46%), previously TB treatment (96.72%), never smoking (75.41%), no contacts with MDR TB patients (86.89%), and never examined for HIV-AIDS (59.02%). The analysis showed there was no significant association between age, sex, previous TB treatment, smoking, contact with MDR TB patients, and HIV-AIDS status with MDR TB incidence in Dr. Sardjito Hospital Yogyakarta (p value >0.05).Conclusion The variables of age, sex, previous TB treatment, smoking, contacts with MDR TB patients, and HIV-AIDS status were not risk factors for MDR TB incidence in Dr. Sardjito Hospital in Yogyakarta.
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Habimana, Dominique Savio, Jean Claude Semuto Ngabonziza, Patrick Migambi, Yves Mucyo-Habimana, Grace Mutembayire, Francine Byukusenge, Innocent Habiyambere, et al. "Predictors of Rifampicin-Resistant Tuberculosis Mortality among HIV-Coinfected Patients in Rwanda." American Journal of Tropical Medicine and Hygiene 105, no. 1 (July 7, 2021): 47–53. http://dx.doi.org/10.4269/ajtmh.20-1361.
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Abstract.Tuberculosis (TB), including multidrug-resistant (MDR; i.e., resistant to at least rifampicin and isoniazid)/rifampicin-resistant (MDR/RR) TB, is the most important opportunistic infection among people living with HIV (PLHIV). In 2005, Rwanda launched the programmatic management of MDR/RR-TB. The shorter MDR/RR-TB treatment regimen (STR) has been implemented since 2014. We analyzed predictors of MDR/RR-TB mortality, including the effect of using the STR overall and among PLHIV. This retrospective study included data from patients diagnosed with RR-TB in Rwanda between July 2005 and December 2018. Multivariable logistic regression was used to assess predictors of mortality. Of 898 registered MDR/RR-TB patients, 861 (95.9%) were included in this analysis, of whom 360 (41.8%) were HIV coinfected. Overall, 86 (10%) patients died during MDR/RR-TB treatment. Mortality was higher among HIV-coinfected compared with HIV-negative TB patients (13.3% versus 7.6%). Among HIV-coinfected patients, patients aged ≥ 55 years (adjusted odds ratio = 5.89) and those with CD4 count ≤ 100 cells/mm3 (adjusted odds ratio = 3.77) had a higher likelihood of dying. Using either the standardized longer MDR/RR-TB treatment regimen or the STR was not correlated with mortality overall or among PLHIV. The STR was as effective as the long MDR/RR-TB regimen. In conclusion, older age and advanced HIV disease were strong predictors of MDR/RR-TB mortality. Therefore, special care for elderly and HIV-coinfected patients with ≤ 100 CD4 cells/mL might further reduce MDR/RR-TB mortality.
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Desel, Tenzin, Naonori Tsuda, Tenzin Tsundue, Rangjung Lingtsang, Sonam Topgyal, Akahito Sako, Hidekatsu Yanai, and Tsetan Sadutshang. "775. An Epidemiological Analysis of Patients With Multidrug-Resistant Tuberculosis Among Tibetan Refugees in India." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S277—S278. http://dx.doi.org/10.1093/ofid/ofy210.782.
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Abstract Background Globally, refugee populations face an increased risk for tuberculosis (TB) due to malnutrition, overcrowding, and poor living conditions. Compared with the general Indian population, Tibetan refugees in India display a higher incidence rate of both TB and multidrug-resistant TB (MDR-TB). The high incidence of MDR-TB in younger population is a serious public health concern. Methods We retrospectively reviewed the medical records of patients with MDR-TB treated from January 2010 to December 2013 in Tibetan Delek Hospital, which is the center of TB control among Tibetan refugees. Patients were classified into either new cases (supposed infection by exposure to MDR-TB) or previously treated MDR-TB cases (suspected acquirement of MDR-TB through anti-TB treatment or by MDR-TB exposure after treatment). We compared patients’ age, sex, birthplace, residence type, occupation, contact history, and treatment outcome. Results Of 749 patients with TB, we enrolled 134 patients with MDR-TB [median age, 26 (interquartile range: 22–35) years; males, 55%]. The Tibetan ethnicity comprised 96% of the study population, whereas Indians (trans-Himalayan) comprised 4%. The birthplace was Tibet for 22% patients, India for 75%, and Nepal for 2%. New MDR-TB cases were 28% and previously treated MDR-TB cases were 72%. Failure was observed in 42% patients and cured and completed in 54% patients, during their previous TB treatment. The median age was significantly lower in new cases than in previously treated MDR-TB cases (24 vs. 28.5 years; P < 0.01). Tibet was the birthplace of 34% new cases and 18% in previously treated cases (P = 0.04). The residence was of the congregated type in 58% of new cases and 30% in previously treated MDR-TB cases (P = 0.01). The occupation was “student” and “unemployed” in 58% and 8% in new cases and 33% and 24% in previously treated cases, respectively (P = 0.03). Contact history with TB type and treatment outcome were not considerably different, although the rates of cured and completed were high in both new (82%) and previously treated (84%) MDR-TB cases. Conclusion This study shows that new MDR-TB correlates with younger age, birth in Tibet, congregated residence, and student occupation. Targeting the above-listed characteristics could be effective in further reducing the MDR-TB transmission among Tibetan refugees in India. Disclosures All authors: No reported disclosures.
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Raazi, Jamil, Shiv Prakash, Khurshid Parveen, and Shama Shaikh. "Risk factors of multi-drug resistant tuberculosis in urban Allahabad, India." International Journal Of Community Medicine And Public Health 4, no. 7 (June 23, 2017): 2383. http://dx.doi.org/10.18203/2394-6040.ijcmph20172828.
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Background: India has the highest burden of tuberculosis globally while second highest in estimated MDR-TB cases after China. The prevalence of MDR-TB is estimated to be 3% among new cases and 14-17% amongst the re-treatment cases. The Objective of the study was to identify the risk factors of MDR-TB in patients registered at tuberculosis units of urban Allahabad.Methods: A cross-sectional study was carried out on TB patients registered at the urban tuberculosis units of Allahabad district in the year 2015. A total of 54 MDR-TB and 1016 non-MDR TB patients were included in the study. A pre-tested structured questionnaire was used to collect the data on the various factors. The chi-square test was used to study the association of various risk factors for MDR-TB patients.Results: MDR-TB was more common in 26-45 year age group (59.26%), males (62.96%), previously treated TB case (83.34%), positive history of contact with MDR-TB patient (5.55%), patients previously on non-DOTS treatment (37.78%), patients with associated co-morbidities (37.03%) and in substance abuse (74.07%) while Non-MDR is more common in >45 years (46.75%) age group, females (56.69%), new cases (87.20%), patients on DOTS therapy (85.16%), without any co-morbidities (83.46%) and in patients having positive history of substance abuse (60.04%).Conclusions: The younger age, male gender previous TB treatment, patients previously on Non-DOTS treatment, incomplete previous TB treatment, positive contact history of MDR-TB cases, presence of associated co-morbidities and substance abuse was significantly associated with MDR-TB patients than Non-MDR-TB patients (p<0.05).
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Bichha, R. P., K. B. Karki, K. K. Jha, V. S. Salhotra, and A. P. Weerakoon. "Barriers to Directly Observed Treatment for Multi Drug Resistant Tuberculosis Patients in Nepal - Qualitative Study." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 16, no. 1 (June 30, 2018): 6–18. http://dx.doi.org/10.3126/saarctb.v16i1.23239.
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Introduction: To prevent the multi drug resistant tuberculosis (MDR-TB) is important to adhere long duration of drug regimen. There are many factors or barriers that are likely to affect adherence to the long treatment regimen.
Objectives: To find out the barriers for adherence to MDR –TB treatment.
Methods: The study was conducted as an institutional based qualitative study, using a convenient sampling technique. Data was collected from 50 current MDR-TB patients by trained field health workers using semi structured interviewer administered questionnaire in all regions in Nepal. Twenty five focus group discussions (FGD) were also conducted with MDR-TB patients, cured MDR-TB patients, DOTS Committee Members, health workers and close relatives of MDR-TB patients to supplement the findings.
Results: Out of 50 respondents 19 were females and 31 were males. Their age varied from 22 years to 61 years. Majority of patients had a previous history of irregular TB treatment. Forty out of fifty patients (80%) were living in either rented houses or hostels (in Mid Western Region). Knowledge about TB and MDR-TB was satisfactory in majority of participants in both studies. Majority of participants were satisfied with facilities and services provided by MDR-TB clinics. There is a very little stigma associated with MDR-TB in Nepal. FGD revealed the onset of MDR-TB was attributed to causes such as smoking, alcohol abuse, poor nutrition, and contact with TB patients. Lack of money to go to health facility daily for treatment was reported as major barriers to adhere to MDR-TB treatment.
Conclusion: Financial constraints were the major barrier for these patients. To sustain proper MDRTB programme, Government of Nepal and other organization should provide social support to these patients.
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Tuladhar, Pranita, Dhruba Kumar Khadka, Megha Raj Banjara, and Reshma Tuladhar. "Second Line Drugs Resistant Mycobacterium Tuberculosis in Multi-Drug Resistant Tuberculosis Patients." Journal of Institute of Science and Technology 22, no. 2 (April 9, 2018): 168–74. http://dx.doi.org/10.3126/jist.v22i2.19609.
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With an increase in Multi-drug resistant tuberculosis (MDR-TB), there is a need of second line drug susceptibility test that helps in early diagnosis and minimize the risk of other powerful drug resistant Mycobacterium tuberculosis. The aim of this study was to determine second line drugs (ofloxacin, kanamycin, capreomycin) resistance pattern in MDR-TB isolates and to determine the prevalence of pre-Extensively drug resistant tuberculosis (pre-XDR-TB) and XDR-TB in MDR-TB patients. The study was conducted from February to September 2015 at National Tuberculosis Centre, Thimi, Bhaktapur. MDR-TB (resistant to isoniazid and rifampicin) patients’ sputum samples were processed by Modified Petroff’s method. Out of 92 samples, 57 were found culture positive. Following the species identification of culture positive MDR-TB isolates, second line drug susceptibility test was performed by conventional proportion method. Of 57 MDR-TB isolates, 22 (38.59%) showed resistance to ofloxacin (Ofx), 9 (15.79%) to capreomycin (Cm) and 9 (15.79%) to kanamycin (Km). One XDR-TB (1.8%) resistant to all drugs was detected. Of the remaining, 21(36.8%) were resistant to ofloxacin only and 8(15.4%) were resistant to two drugs i.e.29 (50.9%) were pre-XDR-TB. The prevalence of pre-XDR-TB and XDR-TB was found to be 50.88% and 1.75% respectively. The resistance pattern of second line anti-tuberculosis drugs showed higher ofloxacin resistance in MDR-TB patients. In a nutshell, MDR-TB cases need urgent and timely susceptibility report for second line anti-tuberculosis drugs to help the clinicians start proper drug combinations to treat MDR-TB patients. Journal of Institute of Science and Technology Volume 22, Issue 2, January 2018, page: 168-174
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Yulianti, Yulianti, and Sally Mahdiani. "Gangguan pendengaran penderita Tuberkulosis Multidrug Resistant." Oto Rhino Laryngologica Indonesiana 45, no. 2 (December 31, 2015): 83. http://dx.doi.org/10.32637/orli.v45i2.112.
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Latar belakang: Tuberkulosis Multidrug Resistant (TB MDR) merupakan penyakit tuberkulosis (TB) yang resisten terhadap isoniazid dan rifampisin, dengan atau tanpa resisten terhadap obat anti- TB lain. Terapi aminoglikosida pada TB MDR berisiko untuk terjadinya gangguan fungsi telinga dan sistem keseimbangan tubuh, yang dapat bersifat irreversible atau permanen. Kerusakan pada koklea dapat menimbulkan penurunan pendengaran permanen. Tujuan: Mengetahui gangguan pendengaran penderita TB MDR di poliklinik TB MDR Ilmu Penyakit Dalam RS Hasan Sadikin Bandung. Metode: Penelitian deskriptif secara retrospektif pada pasien TB MDR yang berobat jalan di poliklinik TB MDR Ilmu Penyakit Dalam Rumah Sakit Hasan Sadikin Bandung periode 1 Januari - 31 Desember 2013. Hasil: Didapatkan gangguan pendengaran sebanyak 20,8% dari pasien TB MDR selama mendapat terapi TB MDR dengan keluhan tinitus dan gangguan pendengaran dengan onset timbulnya keluhan di bulan ke-3 (53,3%), kemudian bulan ke-6 (40%), dan bulan ke-10 (6,7%) setelah mulai pemberian terapi TB MDR. Pada pemeriksaan audiometri nada murni ditemukan penurunan pendengaran sensorineural yang bervariasi dari derajat ringan sampai berat. Kesimpulan: Pengobatan TB MDR dapat menyebabkan penurunan pendengaran sensorineural.Kata Kunci : Tuberkulosis Multidrug Resistant, audiometri nada murni, gangguan pendengaran sensorineural ABSTRACT Background: Multidrug Resistant Tuberculosis (MDR TB) is a tuberculosis (TB) which resistant to isoniazid and rifampin, with or without resistancy to other anti-TB drugs. Aminoglycoside therapy in MDR TB patients takes risks to malfunctioning of the ear and balance system. The hearing loss and balance system impairment that appeared are irreversible/permanent. Cochlear damage can cause permanent hearing loss. Purpose: To describe hearing loss in patients with MDR TB at MDR TB clinic of internal medicine in Hasan Sadikin hospital. Methods: A retrospective descriptive study on MDR TB patients in MDR TB outpatient clinic of Internal Medicine in Hasan Sadikin hospital in the period of January 1st to December 31th, 2013. Results: There were 20,8% of MDR TB patients who received treatment for MDR TB with tinnitus and hearing loss with onset of presentation at the 3rd month (53,3%), at the 6th month (40%), and at the 10th month (6,7%) of MDR TB therapy. Pure tone audiometry examination found sensorineural hearing loss with various degrees from mild to severe. Conclusion: Treatment of MDR TB could cause sensorineural hearing loss.Keywords: Tuberculosis Multidrug Resistant, pure tone audiometric, sensorineural hearing loss
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Elduma, Adel Hussein, Mohammad Ali Mansournia, Abbas Rahimi Foroushani, Hamdan Mustafa Hamdan Ali, Asrar M. A. Salam Elegail, Asma Elsony, and Kourosh Holakouie-Naieni. "Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study." Epidemiology and Health 41 (April 20, 2019): e2019014. http://dx.doi.org/10.4178/epih.e2019014.
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OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients’ adherence to treatment, and to reduce contact with MDR-TB patients.
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Chen, M. P., R. Miramontes, and J. S. Kammerer. "Multidrug-resistant tuberculosis in the United States, 2011–2016: patient characteristics and risk factors." International Journal of Tuberculosis and Lung Disease 24, no. 1 (January 1, 2020): 92–99. http://dx.doi.org/10.5588/ijtld.19.0173.
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OBJECTIVE: To determine risk factors for multidrug-resistant tuberculosis (MDR-TB) and describe MDR-TB according to three characteristics: previous TB disease, recent transmission of MDR-TB, and reactivation of latent MDR-TB infection.SETTING and DESIGN: We used 2011–2016 surveillance data from the US National Tuberculosis Surveillance System and National Tuberculosis Genotyping Service and used logistic regression models to estimate risk factors associated with MDR-TB.RESULTS: A total of 615/45 209 (1.4%) cases were confirmed as MDR-TB; 111/615 (18%) reported previous TB disease; 41/615 (6.7%) were attributed to recent MDR-TB transmission; and 449/615 (73%) to reactivation. Only 12/41 (29%) patients with TB attributed to recent transmission were known to be contacts of someone with MDR-TB. For non-US-born patients, the adjusted odds ratios of having MDR-TB were 32.6 (95%CI 14.6–72.6) among those who were known to be contacts of someone with MDR-TB and 6.5 (95%CI 5.1–8.3) among those who had had previous TB disease.CONCLUSION: The majority of MDR-TB cases in the United States were associated with previous TB disease or reactivation of latent MDR-TB infection; only a small proportion of MDR-TB cases were associated with recent transmission.
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Ainiyah, Safira Nur, Soedarsono Soedarsono, and Pirlina Umiastuti. "Hubungan Peran Keluarga dan Kepatuhan Pasien TB MDR di RSUD Dr. Soetomo Surabaya." Jurnal Respirasi 5, no. 1 (January 30, 2019): 1. http://dx.doi.org/10.20473/jr.v5-i.1.2019.1-4.
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Background: Multi Drug Resistant Tuberculosis (MDR TB) is an infection disease caused by Mycobacterium tuberculosis and has been resistant to isoniazid and rifampicin. Based on medical record of MDR TB Clinic RSUD Dr. Soetomo Surabaya, there is an increase of drop out rate which indicates that MDR TB patient’s adherence is low althouh there are some policies to improve their adherence. Therefore family role is needed for increasing MDR TB patients’ adherence and decreaseing drop out rate.Objective: to know the relationship between family role and MDR TB patient’s adherence on treatment in RSUD Dr. Soetomo Surabaya. Method: This analytical study in cross sectional approach is held on October 2017-June 2018 in MDR TB Clinic of RSUD Dr. Soetomo Surabaya and patients’ house. There are 24 patients and their family which are enrolled and interviewed in this study. Inferential statistic which was Fisher Exact Test used to find out and analyze the relationship between family role and MDR TB patient’s adherence on treatment in RSUD Dr. Soetomo Surabaya. Result: There is no difference frequencies of high and low family role. The MDR TB patients have high adherence. There is significant (p = 0,018) and moderate (c = 0,452) relationship of family role and MDR TB patients’ adherence on treatment in RSUD Dr. Soetomo Surabaya.Conclusion: To improve MDR TB patients’ adherence, family must have a significant role and give support. Health provider also should give education about importance of family role in MDR TB patients’ treatment.
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Leimane, V., and J. Leimans. "Tuberculosis control in Latvia: integrated DOTS and DOTS-plus programmes." Eurosurveillance 11, no. 3 (March 1, 2006): 17–18. http://dx.doi.org/10.2807/esm.11.03.00610-en.
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From 1991 until the end of 1998, the number of patients with tuberculosis in Latvia increased 2.5 times with a simultaneous increase of drug resistant and multidrug resistant tuberculosis (MDR-TB). Descriptive analysis of different TB programme services, activities and strategies including Directly Observed Therapy Short-course (DOTS) for tuberculosis and treatment of MDR-TB, were performed. Data from the state tuberculosis registry, drug resistance surveillance, and the national MDR-TB database were used. The state-funded national tuberculosis control programme (NTAP, Nacionâlâ Tuberkulozes Apkarodanas Programma), based on WHO recommended DOTS strategy, was introduced in Latvia in 1996. The NTAP includes TB control in prisons. Treatment of MDR-TB using second line drugs was started in 1997. Cure rates for TB patients increased from 59.5% in 1996 to 77.5% in 2003. Between 1996 and 2003, more than 200 patients began MDR-TB treatment each year, and the cure rate was between 66% and 73%. Numbers of MDR-TB patients were reduced by more than half during this period. Treatment results including MDR-TB reached the WHO target, with cure rates 85% of newly diagnosed patients. These results demonstrate that MDR-TB treatment and management using the individualised treatment approach can be effectively provided within the overall TB programme on a national scale, to successfully treat a large number of MDR-TB patients. Rapid diagnostic methods combined with early intensified case finding, isolation and infection control measures could decrease transmission of TB and MDR-TB in hospitals and in the community. Highly important that MDR-TB management follows WHO recommendations in order to stop creating drug resistance to first and to second line drugs.
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Thiruvalluvan, E., B. Thomas, C. Suresh, S. Sellappan, M. Muniyandi, and B. Watson. "THE PSYCHOSOCIAL CHALLENGES FACING MULTI DRUG RESISTANCE TUBERCULOSIS PATIENTS: A QUALITATIVE STUDY." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 14, no. 1 (July 12, 2017): 14–21. http://dx.doi.org/10.3126/saarctb.v14i1.17724.
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Background: The treatment for MDR-TB characterized by rigorous treatment regimen for long duration, higher incidence of adverse side effects, lower cure rate, and high treatment costs. This could lead to number of psychosocial problems that influence treatment adherence. MDR-TB patients registered under DOTS Plus programme during the period of 2013-2014 in Chennai and Madurai districts, of Tamilnadu were included for this study.Objective: To understand the psychosocial issues facing MDR-TB patients, who are diagnosed and registered for treatment under DOTS plus programme.Methodology: This study used Focus Group Discussions with people with MDR-TB. Focus Group Discussions were focused on physical, psychological, social and economical challenges which MDR-TB patients faced during their treatment.Results: Most of the study participants did not disclose their TB status, even to their family members. The majority of patients were not aware of the diagnosis of MDR-TB and long duration of treatment. Stigma from family, community and health providers has been experienced by the majority of patients. Patients and their families were afraid of losing economic stability which was already precarious owing to the disease. This fear has often generated a great deal of stress.Conclusion: Study finding indicates that there is a significant psychological, social, and financial impact of MDR-TB that has a direct impact on quality of life of MDR-TB patients and their families. There is a need for psychosocial intervention model (strategies) for MDR-TB patients and their caregivers to mitigate the negative effects.SAARC J TUBER LUNG DIS HIV/AIDS, 2017; XIV(1), page: 14-21
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Mardining Raras, Tri Yudani, Triwahju Astuti, and Iin Noor Chozin. "Soluble Urokinase Plasminogen Activator Receptor Levels in Tuberculosis Patients at High Risk for Multidrug Resistance." Tuberculosis Research and Treatment 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/240132.
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The soluble urokinase plasminogen activator receptor (suPAR) has been shown to be a strong prognostic biomarker for tuberculosis (TB). In the present study, the profiles of plasma suPAR levels in pulmonary TB patients at high risk for multidrug resistance were analyzed and compared with those in multidrug resistant (MDR)-TB patients. Forty patients were prospectively included, consisting of 10 MDR-TB patients and 30 TB patients at high risk for MDR, underwent clinical assesment. Plasma suPAR levels were measured using ELISA (SUPARnostic, Denmark) and bacterial cultures were performed in addition to drug susceptibility tests. All patients of suspected MDR-TB group demonstrated significantly higher suPAR levels compared with the healthy TB-negative group (1.79 ng/mL). Among the three groups at high risk for MDR-TB, only the relapse group (7.87 ng/mL) demonstrated suPAR levels comparable with those of MDR-TB patients (7.67 ng/mL). suPAR levels in the two-month negative acid-fast bacilli conversion group (9.29 ng/mL) were higher than positive control, whereas levels in the group consisting of therapy failure patients (5.32 ng/mL) were lower. Our results strongly suggest that suPAR levels enable rapid screening of suspected MDR-TB patients, but cannot differentiate between groups.
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Cornish, Emily F., Jonathan Hudson, Ross Sayers, and Marian Loveday. "Improving access to contraception through integration of family planning services into a multidrug-resistant tuberculosis treatment programme." BMJ Sexual & Reproductive Health 46, no. 2 (November 27, 2019): 152–55. http://dx.doi.org/10.1136/bmjsrh-2019-200400.
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ObjectivesMultidrug-resistant tuberculosis (MDR-TB) is a global public health priority. The advent of the World Health Organisation’s Short Course regimen for MDR-TB, which halves treatment duration, has transformed outcomes and treatment acceptability for affected patients. Bedaquiline, a cornerstone of the Short Course regimen, has unknown teratogenicity and the WHO therefore recommends reliable contraception for all female MDR-TB patients in order to secure eligibility for bedaquiline. We were concerned that low contraceptive uptake among female patients in our rural South African MDR-TB treatment programme could jeopardise their access to bedaquiline. We therefore conducted a service delivery improvement project that aimed to audit contraceptive use in female MDR-TB patients, integrate family planning services into MDR-TB care, and increase the proportion of female patients eligible for bedaquiline therapy.MethodsContraceptive use and pregnancy rates were audited in all female patients aged 13–50 years initiated on our MDR-TB treatment programme in 2016. We then implemented an intervention consisting of procurement of depot-medroxyprogesterone acetate (DMPA) for the MDR-TB unit and training of specialist MDR-TB nurses in administration of DMPA. The audit cycle was repeated for all female patients aged 13–50 years initiated on the programme in January–October 2017 (post-intervention).ResultsThe proportion of women on injectable contraceptives by the time of MDR-TB treatment initiation increased significantly in the post-intervention cohort (77.4% vs 23.9%, p<0.0001).ConclusionBy integrating contraceptive services into our MDR-TB programme we significantly increased contraceptive uptake, protecting women from the obstetric risks associated with pregnancy during MDR-TB treatment and maximising their eligibility for bedaquiline therapy.
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Butov, D., C. Lange, J. Heyckendorf, I. Kalmykova, T. Butova, N. Borovok, M. Novokhatskaya, and D. Chesov. "Multidrug-resistant tuberculosis in the Kharkiv Region, Ukraine." International Journal of Tuberculosis and Lung Disease 24, no. 5 (May 1, 2020): 485–91. http://dx.doi.org/10.5588/ijtld.19.0508.
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OBJECTIVE: To document the level of drug resistance in MDR-TB patients and to characterize management capacities for their medical care and MDR-TB treatment outcomes in the Kharkiv region of Ukraine. This area has one of the highest frequencies of MDR-TB worldwide.METHODS: A retrospective observational cohort study was performed on registry data from the regional anti-TB dispensary in Kharkiv. All microbiologically confirmed MDR-TB patients registered in 2014 were included. Diagnostic, treatment and post-treatment follow-up data were analysed.RESULTS: Of 169 patients with MDR-TB, 55.0% had pre-extensively drug-resistant (pre-XDR) or XDR resistant patterns. Rapid molecular diagnosis by GeneXpert and liquid M. tuberculosis cultures were only available for 66.9% and 56.8% of patients, respectively. Phenotypic drug-susceptibility testing (DST) for high priority TB drugs (bedaquiline, linezolid, clofazimine) were not available. DST for later generation fluroquinolones was available only in 53.2% of patients. 50.9% of patients had less than 4 drugs in the treatment regimen proven to be effective by DST. More than 23.1% of patients with MDR-TB failed their treatment and only 45.0% achieved a cure.CONCLUSION: The high prevalence of MDR-TB and poor MDR-TB treatment outcomes in the Kharkiv region, is associated with substantial shortages in rapid molecular and phenotypic DST, a lack of high priority MDR-TB drugs, poor treatment monitoring and follow-up capacities.
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Chaudhary, A., T. Mahmood, A. D. Shukla, A. Shreenivasa, Verma Arvind, K. Ahmad, and A. Verma. "Association of Socio-Demographic Profile with Prevalence of Multi Drug Resistant Tuberculosis among Retreated Pulmonary Tuberculosis Patients in North India." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 16, no. 1 (June 30, 2018): 1–5. http://dx.doi.org/10.3126/saarctb.v16i1.23238.
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Methods: An observational cross sectional study, which includes 116 patients of sputum smear positive pulmonary TB of age 18 or above. Further, detailed history taking regarding different demographic profile was done. Also, they were subjected to CB-NAAT and rifampicin resistant cases were considered as MDR-TB.
Results: Proportion of MDR-TB was 31.89% among retreatment TB cases. 56.75 % (n=21) of MDR-TB cases were between the age group of 21-40 years. Proportion of MDR-TB was higher among males (75.67%), married (59.45%) and rural dwellers 59.45%. Proportion was 61.76% among patients with BMI <16; 31.57% with BMI 16-16.99, 28.57% with BMI 17-18.49 and 5.7% with BMI 18.50-24.99. MDRTB proportion was less 29.72% (n=11) in patients with history of TB contact in family. Pulmonary TB including MDR-TB was more common among illiterates (37.83% among MDR).
Conclusion: Proportion of MDR-TB was high among retreatment cases in north India. Among them low BMI and education status are modifiable factor and this study signifies that MDR-TB burden can be reduced by improving health and education status of patient.
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Mulyanto, Heri. "Relationship Five Behavioral Indicators and Healthy Living with Tuberculosis Multidrug-Resistant." Jurnal Berkala Epidemiologi 2, no. 3 (September 1, 2014): 355. http://dx.doi.org/10.20473/jbe.v2i3.2014.355-367.
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ABSTRACTClean and healthy life style is a behavior that is closely related to the emergence of infectious diseases, including TB continued into MDR-TB. This study aimed to determine the relationship between the 5 behavioral indicators of clean and healthy living with MDR-TB in Dr. Saiful Anwar Hospital. Research was conducted used a retrospective analytic designed by case control study. Subjects drawn from a population with a simple random sampling with a ratio of 1: 1 between cases and controls, patients of MDR-TB in TB clinic as many as 27 patients as cases group and patients who had undergone TB treatment for at least 6 months with a negative smear results by 27 patients as a control group. The variables in this study were healthy and hygienic behavior, and several other variable and MDR-TB The variables in this study were healthy and hygienic behavior, demographic variables and MDR-TB. Research results calculated used Chi Square test with a confidence level of 95% (α = 0.05) showed age, gender, education level and marital status was not associated with MDR- TB, nutritional eating life style associated with MDR-TB (OR = 0,25 and p = 0.014), exercise life style (physical activity) associated with MDR-TB (OR = 0,16 and p = 0.00), utilizing life style health care facilities associated with MDR-TB (OR= 0,091 and p = 0.01), life style to prevent co-infections was not associated with MDR-TB (p = 0.78), and the provision of a healthy home environment behaviors associated with TB multidrug-resistant (OR = 0,28 and p = 0.03). There are four variables of clean and healthy life style associated with MDR-TB, so that health care facilities are advised to give the promotion of clean and healthy life style TB patients to prevent progression to MDR-TB.Keywords: Clean and Healthy Life Style, multidrug resistant tuberculosis
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Mulyanto, Heri. "Relationship Five Behavioral Indicators and Healthy Living with Tuberculosis Multidrug-Resistant." Jurnal Berkala Epidemiologi 2, no. 3 (September 1, 2014): 355. http://dx.doi.org/10.20473/jbe.v2i32014.355-367.
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ABSTRACTClean and healthy life style is a behavior that is closely related to the emergence of infectious diseases, including TB continued into MDR-TB. This study aimed to determine the relationship between the 5 behavioral indicators of clean and healthy living with MDR-TB in Dr. Saiful Anwar Hospital. Research was conducted used a retrospective analytic designed by case control study. Subjects drawn from a population with a simple random sampling with a ratio of 1: 1 between cases and controls, patients of MDR-TB in TB clinic as many as 27 patients as cases group and patients who had undergone TB treatment for at least 6 months with a negative smear results by 27 patients as a control group. The variables in this study were healthy and hygienic behavior, and several other variable and MDR-TB The variables in this study were healthy and hygienic behavior, demographic variables and MDR-TB. Research results calculated used Chi Square test with a confidence level of 95% (α = 0.05) showed age, gender, education level and marital status was not associated with MDR- TB, nutritional eating life style associated with MDR-TB (OR = 0,25 and p = 0.014), exercise life style (physical activity) associated with MDR-TB (OR = 0,16 and p = 0.00), utilizing life style health care facilities associated with MDR-TB (OR= 0,091 and p = 0.01), life style to prevent co-infections was not associated with MDR-TB (p = 0.78), and the provision of a healthy home environment behaviors associated with TB multidrug-resistant (OR = 0,28 and p = 0.03). There are four variables of clean and healthy life style associated with MDR-TB, so that health care facilities are advised to give the promotion of clean and healthy life style TB patients to prevent progression to MDR-TB.Keywords: Clean and Healthy Life Style, multidrug resistant tuberculosis
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Baqar, Tanish, Sharique Ahmad, and Silky Rai. "OTOTOXICITY IN MDR-TB PATIENTS ON CATEGORY-4 REGIMEN: A CASE REPORT." Era's Journal of Medical Research 7, no. 2 (December 2020): 257–59. http://dx.doi.org/10.24041/ejmr2020.45.
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Multiple drug-resistant tuberculosis (MDR-TB) is a critical situation affecting adults as properly as children across the globe (1). To determine the incidence and risk factors associated with Multiple Drug Resistant Tuberculosis (MDR-TB) (2), we studied Ototoxicity on 18 culture confirmed MDR-TB patients in Eras' Lucknow Medical College and Hospital, Lucknow from September, 2019 to January, 2020. This case follows a well documented report of a patient describing an unusual and novel occurrence of ototoxicity when undergoing treatment concerning multiple drug resistance tuberculosis along with symptoms, signs, diagnosis, treatment and follow-up (3). For descriptive convenience, the patient will be classified as patient 1. The following case is the cornerstones of medical progress and provides many new ideas in medicine. Containing an extensive review of the relevant literature on the topic, the case report is a rapid short communication between busy clinicians who may not have time or resources to conduct large scale research.(4)
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Lihawa, Nurjanah, and Resti Yudhawati. "Hubungan Kadar Interleukin-10 dan Tuberkulosis Multi-Drug Resistant." Jurnal Respirasi 1, no. 2 (April 1, 2019): 41. http://dx.doi.org/10.20473/jr.v1-i.2.2015.41-47.
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Background: Prevalence of multi-drug resistant tuberculosis (MDR-TB) is increased by the time. In Indonesia, there were an estimated 1.9% of new cases and 12% of previously treated cases. Protection against Mycobacterium tuberculosis is dependent on Th1 cell CD4+ that produced pro-inflammatory cytokines such as IFN-γ and TNF-α. T cell regulators (Tregs) produced IL-10 as anti- inflammatory cytokine is against the function of those pro-inflammatory cytokines. It is believed that immune suppression is responsible for MDR-TB. The previous study showed impaired Th1 responses and enhanced regulatory T-cell levels in circulatory blood of MDR- TB patients. The study of IL-10 represented anti-inflammation cytokine as immune suppression never been conducted in Indonesia. Objective: To analyze relationship between level of interleukin-10 and Multi-drug resistant tuberculosis. Methods: The study was conducted at the outpatient department of MDR-TB and DOTS of Dr. Soetomo hospital in Surabaya. Total sample was 38 of TB patients that consist of 19 MDR-TB patients (secondary resistant) and 19 non-MDR TB patients as control. Results: In this study we found that the median level of IL-10 as 5.7±3.3 pg/mL in the group of MDR-TB patients with minimum level was 1.3 pg/mL and maximum level was 14.0 pg/mL while median level of IL-10 in non-MDR TB patients was 7.0±3.4 pg/mL with 3.2 pg/mL and 16.5 pg/mL, respectively. To analyze correlation between time to first of having TB until became MDR-TB and level of IL-10 by using Pearson’s correlation, we showed that no statistical correlation (p>0.05). According to statistical classification, we found that no statistical correlation between level of IL-10 and the history of treatment in MDR-TB patients (p>0.05). Data showed that all the history of treatment classification dominated by MDR-TB patients with the low level of IL-10. We also found that no statistical difference with the level of IL-10 in MDR- TB and non-MDR TB patients (p>0.05) although in descriptive state we found the level of IL-10 was higher in non-MDR TB patients. And also there was no relationship between level of IL-10 and MDR-TB (p>0.05). It could be explained that the host factor was not involved and in the other side we still not known the factor of agents, yet. The low level of IL-10 that was observed in this study could be interfering by the strain of M.tb which not assessed in this study. Conclusion: In this study we found that level of IL-10 is not increase in MDR-TB patients and there was no relationship between level of IL-10 and MDR-TB (p>0.05).
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Patel, Disha S., and Chetankumar R. Acharya. "Impact of shorter MDR tuberculosis regimen drugs on heart rate variability in MDR tuberculosis patients at tertiary care hospital." International Journal of Basic & Clinical Pharmacology 10, no. 7 (June 22, 2021): 813. http://dx.doi.org/10.18203/2319-2003.ijbcp20212378.
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Background: Tuberculosis is major cause of death in India. Analysis of heart rate variability is one of the most popular methods of autonomic nervous system evaluation. Shorter MDR-TB regimen drugs affect both central nervous system as well as peripheral nervous system. Existing research suggests that active pulmonary tuberculosis causes ANS dysfunction. So, by HRV measurement impact of shorter MDR-TB regimen drugs on autonomic dysfunction can be correlated. Aim of the current investigation was to evaluate effect of shorter MDR-TB regimen drugs on cardiac autonomic regulation in MDR-TB patients with respect to heart rate variability as a parameter.Methods: Fifty newly diagnosed MDR-TB patients of either gender on shorter MDR- TB regimen were enrolled in this study after taking consent. After 20 minutes rest, ECG was taken by “physiopac digital polygraph” software for 5 minutes. Two follow-up HRV assessments were done on 2nd month and 4th or 6th month of treatment. HRV was calculated by root mean square deviation of successive differences between adjacent RR intervals (RMSSD) and low frequency and high frequency ratio.Results: Repeated measures ANOVA showed no statistically significant difference in HRV parameters between baseline, 2 months and 6 months groups. So, sympathetic and parasympathetic modulation in terms of HRV remains unchanged during treatment of MDR-TB with shorter MDR-TB regimen drugs.Conclusions: Shorter MDR-TB regimen drugs don’t have any significant impact on HRV in MDR- TB patients, No correlation was observed between HRV and heart rate in MDR-TB patients.
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Elmi, Omar Sald, Habsah Hasan, Sarimah Abdullah, Mat Zuki Mat Jeab, Zilfalil Bin Alwi, and Nyi Nyi Naing. "Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study." Journal of Infection in Developing Countries 9, no. 10 (October 29, 2015): 1076–85. http://dx.doi.org/10.3855/jidc.6162.
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Introduction: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a major clinical public health threat and challenges the national TB control program in Malaysia. Data that elaborates on the risk factors associated with the development of MDR-TB is highly limited in this country. This study was aimed to determine the risk factors associated with the development of MDR-TB patients in peninsular Malaysia. Methodology: This was a case control study; the data were collected from medical records of all the registered MDR-TB patients at five referral TB hospitals in peninsular Malaysia from January 2010 to April 2014. The 105 cases were all confirmed by a positive sputum culture of Mycobacterium tuberculosis for MDR-TB and extensively drug-resistant (XDR)-TB. As a comparison, a total of 209 non-MDR-TB cases were randomly selected as controls. Results: A total of 105 MDR-TB and 209 non MDR-TB patients were studied. The risk factors associated with MDR-TB within the multivariate analysis were previous tuberculosis treatment, HIV infection, being an immigrant, and high load of positive for acid-fast bacillus (AFB) smear. Conclusions: The findings of this study revealed that patients who had received previous treatment for tuberculosis, were infected with HIV, were immigrants, and had a high burden of positive testing for AFB smear were more likely to have MDR-TB. An enhanced understanding of the risk factors associated with MDR-TB strains is imperative in the development of a national policy for public health interventions.
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Srinivasan, Vijay, Vu T. N. Ha, Dao N. Vinh, Phan V. K. Thai, Dang T. M. Ha, Nguyen H. Lan, Hoang T. Hai, et al. "Sources of Multidrug Resistance in Patients With Previous Isoniazid-Resistant Tuberculosis Identified Using Whole Genome Sequencing: A Longitudinal Cohort Study." Clinical Infectious Diseases 71, no. 10 (March 13, 2020): e532-e539. http://dx.doi.org/10.1093/cid/ciaa254.
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Abstract Background Meta-analysis of patients with isoniazid-resistant tuberculosis (TB) given standard first-line anti-TB treatment indicated an increased risk of multidrug-resistant TB (MDR-TB) emerging (8%), compared to drug-sensitive TB (0.3%). Here we use whole genome sequencing (WGS) to investigate whether treatment of patients with preexisting isoniazid-resistant disease with first-line anti-TB therapy risks selecting for rifampicin resistance, and hence MDR-TB. Methods Patients with isoniazid-resistant pulmonary TB were recruited and followed up for 24 months. Drug susceptibility testing was performed by microscopic observation drug susceptibility assay, mycobacterial growth indicator tube, and by WGS on isolates at first presentation and in the case of re-presentation. Where MDR-TB was diagnosed, WGS was used to determine the genomic relatedness between initial and subsequent isolates. De novo emergence of MDR-TB was assumed where the genomic distance was 5 or fewer single-nucleotide polymorphisms (SNPs), whereas reinfection with a different MDR-TB strain was assumed where the distance was 10 or more SNPs. Results Two hundred thirty-nine patients with isoniazid-resistant pulmonary TB were recruited. Fourteen (14/239 [5.9%]) patients were diagnosed with a second episode of TB that was multidrug resistant. Six (6/239 [2.5%]) were identified as having evolved MDR-TB de novo and 6 as having been reinfected with a different strain. In 2 cases, the genomic distance was between 5 and 10 SNPs and therefore indeterminate. Conclusions In isoniazid-resistant TB, de novo emergence and reinfection of MDR-TB strains equally contributed to MDR development. Early diagnosis and optimal treatment of isoniazid-resistant TB are urgently needed to avert the de novo emergence of MDR-TB during treatment.
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Fitriya, Lailatul, and Kurnia Dwi Artanti. "TREATMENT OUTCOMES OF MULTIDRUG RESISTANT TUBERCULOSIS PATIENTS IN EAST JAVA FROM 2014 TO 2017." Jurnal Berkala Epidemiologi 8, no. 2 (May 31, 2020): 141. http://dx.doi.org/10.20473/jbe.v8i22020.141-148.
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Background: Multidrug resistant tuberculosis (MDR TB) is a major public health problem marked by the Mycobacterium tuberculosis strain that is resistant to first line anti TB drugs, including rifampicin and isoniazid simultaneously. A patient confirmed as having MDR TB can transmit this form of TB to other individuals. Therefore, treatment success is the main target when addressing MDR TB. Purpose: This study aimed to assess the treatment outcomes of MDR TB patients in East Java Province from 2014 to 2017. Method: This is a quantitative-descriptive study using the secondary data of drug resistant TB patients sourced from the e-TB Manager website in the East Java Province Health Office. Results: The results show that the average MDR TB patients was 47 years old, 57.44% were male, 37.52% had a negative HIV status, 44.87% were relapse patients, 71.95% had undergone two or less previous treatments, and 69.24% had sputum culture conversion. The treatment outcomes included 161 patients (31.14%) confirmed as cured, 27 patients (5.22%) completing treatment, 174 patients (33.65%) defaulting, two patients (0.38%) confirmed as having failed treatment, and 59 patients (11.41%) dying during the treatment period. Conclusion: The treatment success rate was low and the number of defaults was high. Therefore, it is hoped that there will be support from those closest to the patient and health workers who will maintain and increase the patient's motivation to complete the treatment.
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Pym, Alexander S., Andreas H. Diacon, Shen-Jie Tang, Francesca Conradie, Manfred Danilovits, Charoen Chuchottaworn, Irina Vasilyeva, et al. "Bedaquiline in the treatment of multidrug- and extensively drug-resistant tuberculosis." European Respiratory Journal 47, no. 2 (December 2, 2015): 564–74. http://dx.doi.org/10.1183/13993003.00724-2015.
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Bedaquiline, a diarylquinoline, improved cure rates when added to a multidrug-resistant tuberculosis (MDR-TB) treatment regimen in a previous placebo-controlled, phase 2 trial (TMC207-C208; NCT00449644). The current phase 2, multicenter, open-label, single-arm trial (TMC207-C209; NCT00910871) reported here was conducted to confirm the safety and efficacy of bedaquiline.Newly diagnosed or previously treated patients with MDR-TB (including pre-extensively drug-resistant (pre-XDR)-TB or extensively drug-resistant (XDR)-TB) received bedaquiline for 24 weeks with a background regimen of anti-TB drugs continued according to National TB Programme treatment guidelines. Patients were assessed during and up to 120 weeks after starting bedaquiline.Of 233 enrolled patients, 63.5% had MDR-TB, 18.9% had pre-XDR-TB and 16.3% had XDR-TB, with 87.1% having taken second-line drugs prior to enrolment. 16 patients (6.9%) died. 20 patients (8.6%) discontinued before week 24, most commonly due to adverse events or MDR-TB-related events. Adverse events were generally those commonly associated with MDR-TB treatment. In the efficacy population (n=205), culture conversion (missing outcome classified as failure) was 72.2% at 120 weeks, and 73.1%, 70.5% and 62.2% in MDR-TB, pre-XDR-TB and XDR-TB patients, respectively.Addition of bedaquiline to a background regimen was well tolerated and led to good outcomes in this clinically relevant patient cohort with MDR-TB.
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Verma, Pushpinder, Balbir Singh, Pramod K. Shridhar, Gurmeet Singh, Sukhjinder Pal Singh, and Parth Rajdev. "Prevalence of multi-drug resistant tuberculosis and factors associated with treatment outcome in three districts of Himachal Pradesh, India." International Journal Of Community Medicine And Public Health 8, no. 7 (June 25, 2021): 3300. http://dx.doi.org/10.18203/2394-6040.ijcmph20212353.
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Background: Tuberculosis (TB) is a leading cause of morbidity and mortality in the world and especially in India. MDR TB has emerged as a major challenge in TB control in India. The prevalence of MDR TB is on the rise in India. We did this study to see the prevalence of MDR TB in 3 districts of Himachal Pradesh and to study the factors affecting treatment outcomes.Methods: The period of the study was from January 2019 to December 2019. We collected data of MDR TB patients from district TB offices of Solan, Bilaspur and Hamirpur. Information from patients was collected through questionnaires while interviews were conducted with district project officer and other health officials and documents, brochures, etc. were collected from Solan, Hamirpur and Bilaspur.Results: Overall prevalence rate of MDR TB in our study was 3.14%. Among new TB cases, the prevalence rate of MDR TB was 2.42% (81/3345), and among old treated cases was 9% (37/411). 31% MDR TB patients were old treated while 69% patients had no previous treatment history. The default rate was low in our study (0.84%) while 8 (6.4%) patients had treatment interruption but for less than 15 days.Conclusions: The prevalence in our study is comparable to the national drug resistance survey. Early detection, timely treatment and contact tracing is vital in decreasing the MDR TB cases. Better supervision, constant monitoring, proper counselling and timely identification and management of adverse effects of the drugs will improve the treatment outcome among MDR TB patients.
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van Rijn, Sander P., Richard van Altena, Onno W. Akkerman, Dick van Soolingen, Tridia van der Laan, Wiel C. M. de Lange, Jos G. W. Kosterink, Tjip S. van der Werf, and Jan-Willem C. Alffenaar. "Pharmacokinetics of ertapenem in patients with multidrug-resistant tuberculosis." European Respiratory Journal 47, no. 4 (January 7, 2016): 1229–34. http://dx.doi.org/10.1183/13993003.01654-2015.
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Treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) is becoming more challenging because of increased levels of drug resistance against second-line TB drugs. One promising group of antimicrobial drugs is carbapenems. Ertapenem is an attractive carbapenem for the treatment of MDR- and XDR-TB because its relatively long half-life enables once-daily dosing.A retrospective study was performed for all patients with suspected MDR-TB at the Tuberculosis Center Beatrixoord of the University Medical Center Groningen (Haren, the Netherlands) who received ertapenem as part of their treatment regimen between December 1, 2010 and March 1, 2013. Safety and pharmacokinetics were evaluated.18 patients were treated with 1000 mg ertapenem for a mean (range) of 77 (5–210) days. Sputum smear and culture were converted in all patients. Drug exposure was evaluated in 12 patients. The mean (range) area under the concentration–time curve up to 24 h was 544.9 (309–1130) h·mg·L−1. The mean (range) maximum observed plasma concentration was 127.5 (73.9–277.9) mg·L−1.In general, ertapenem treatment was well tolerated during MDR-TB treatment and showed a favourable pharmacokinetic/pharmacodynamic profile in MDR-TB patients. We conclude that ertapenem is a highly promising drug for the treatment of MDR-TB that warrants further investigation.
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Mollel, Edson, Isack Lekule, Lutgarde Lynen, and Tom Decroo. "Effect of reliance on Xpert MTB/RIF on time to treatment and multidrug-resistant tuberculosis treatment outcomes in Tanzania: a retrospective cohort study." International Health 11, no. 6 (February 26, 2019): 520–27. http://dx.doi.org/10.1093/inthealth/ihz005.
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Abstract Background During 2009–2013, Xpert MTB/RIF testing was decentralized in Tanzania. Standardized treatment of multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) was centralized at the Kibong’oto Infectious Diseases Hospital. Initially, Xpert MTB/RIF results were confirmed and complemented with phenotypic drug susceptibility testing before MDR-TB treatment was started. Since 2013, the decision to start MDR-TB treatment in patients with RR-TB relied on Xpert MTB/RIF results. Methods A retrospective cohort study of predictors of unsuccessful treatment outcomes (including death, lost to follow-up and treatment failure) was carried out. Results During the study period, 201 patients started MDR-TB treatment. The number of patients starting MDR-TB treatment increased over time. Out of 201 patients, 48 (23.9%) had an unsuccessful treatment outcome. The median time between sample collection and MDR-TB treatment initiation was reduced from 155 d (IQR 40–228) in the 2009–2012 period to 26 d (IQR 13–64) in 2013. Patients who started MDR-TB treatment in 2013 were more likely (adjusted OR 2.3; 95% CI 1.1–4.7; p=0.02) to have an unsuccessful treatment outcome. Conclusions Xpert MTB/RIF testing increased enrolment on MDR-TB treatment. Reliance on Xpert MTB/RIF results to start MDR-TB treatment reduced time to treatment. However, treatment outcomes did not improve.
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Oliveira, Olena, Rita Gaio, Margarida Correia-Neves, Teresa Rito, and Raquel Duarte. "Evaluation of drug-resistant tuberculosis treatment outcome in Portugal, 2000–2016." PLOS ONE 16, no. 4 (April 20, 2021): e0250028. http://dx.doi.org/10.1371/journal.pone.0250028.
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Treatment of drug-resistant tuberculosis (TB), which is usually less successful than that of drug-susceptible TB, represents a challenge for TB control and elimination. We aimed to evaluate treatment outcomes and to identify the factors associated with death among patients with MDR and XDR-TB in Portugal. We assessed MDR-TB cases reported for the period 2000–2016, using the national TB Surveillance System. Treatment outcomes were defined according to WHO recommendations. We identified the factors associated with death using logistic regression. We evaluated treatment outcomes of 294 MDR- and 142 XDR-TB patients. The treatment success rate was 73.8% among MDR- and 62.7% among XDR-TB patients (p = 0.023). The case-fatality rate was 18.4% among MDR- and 23.9% among XDR-TB patients. HIV infection (OR 4.55; 95% CI 2.31–8.99; p < 0.001) and resistance to one or more second-line injectable drugs (OR 2.73; 95% CI 1.26–5.92; p = 0.011) were independently associated with death among MDR-TB patients. HIV infection, injectable drug use, past imprisonment, comorbidities, and alcohol abuse are conditions that were associated with death early on and during treatment. Early diagnosis of MDR-TB and further monitoring of these patients are necessary to improve treatment outcome.
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Akinleye, C. A., A. Onabule, A. O. Oyekale, M. O. Akindele, O. J. Babalola, and S. O. Olarewaju. "Peer reviewed abstract submitted to the College of Health Sciences, Osun State University Annual Scientific Conference, June 15-19, 2020." Research Journal of Health Sciences 8, no. 2 (July 3, 2020): 146–51. http://dx.doi.org/10.4314/rejhs.v8i2.10.
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Introduction: MDR-TB poses a significant challenge to global management of TB. Laboratories in many countries among which include Nigeria are unable to evaluate drug resistance, and clinical predictors of MDR-TB might help target suspected patients.Method: The study was a cross sectional study design. Multistage sampling technique was employed in the selection of 403 tuberculosis patients. Data were analyzed using SPSS version 25. Level of significance was set at P<0.05.Results: Fifty three 53 (13.2%) of the total respondent had MDR-TB compare to national prevalence of 8% which is steeper among males 36(67.9%) (p>0.05). Education and Occupation shows a significant association with MDR-TB, (÷2=24.640, p = 0.007) and (÷2=14.416, p=0.006) respectively, smoking (r=0.074, p<0.05) and alcohol consumption (r=0.083, p>0.05) show no significant association with occurrence MDR-TB.Conclusion: Previous TB treatment and Adherence with treatment regimen were found to be the major risk factor for MDR-TB. Targeted educational intervention for patients and their contacts may minimize the non-adherence with prescribed TB treatment and lessen MDR-TB magnitude.
Key words: TB Patients, MDR-TB, tuberculosis, risk factors.
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Brode, Sarah K., Robert Varadi, Jane McNamee, Nina Malek, Sharon Stewart, Frances B. Jamieson, and Monica Avendano. "Multidrug-Resistant Tuberculosis: Treatment and Outcomes of 93 Patients." Canadian Respiratory Journal 22, no. 2 (2015): 97–102. http://dx.doi.org/10.1155/2015/359301.
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BACKGROUND: Tuberculosis (TB) remains a leading cause of death worldwide and the emergence of multidrug-resistant TB (MDR TB) poses a threat to its control. There is scanty evidence regarding optimal management of MDR TB. The majority of Canadian cases of MDR TB are diagnosed in Ontario; most are managed by the Tuberculosis Service at West Park Healthcare Centre in Toronto. The authors reviewed 93 cases of MDR TB admitted from January 1, 2000 to December 31, 2011.RESULTS: Eighty-nine patients were foreign born. Fifty-six percent had a previous diagnosis of TB and most (70%) had only pulmonary involvement. Symptoms included productive cough, weight loss, fever and malaise. The average length of inpatient stay was 126 days. All patients had a peripherally inserted central catheter for the intensive treatment phase because medications were given intravenously. Treatment lasted for 24 months after bacteriologic conversion, and included a mean (± SD) of 5±1 drugs. A successful outcome at the end of treatment was observed in 84% of patients. Bacteriological conversion was achieved in 98% of patients with initial positive sputum cultures; conversion occurred by four months in 91%.CONCLUSIONS: MDR TB can be controlled with the available anti-TB drugs.
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Heyckendorf, Jan, Sebastian Marwitz, Maja Reimann, Korkut Avsar, Andrew R. DiNardo, Gunar Günther, Michael Hoelscher, et al. "Prediction of anti-tuberculosis treatment duration based on a 22-gene transcriptomic model." European Respiratory Journal 58, no. 3 (February 11, 2021): 2003492. http://dx.doi.org/10.1183/13993003.03492-2020.
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BackgroundThe World Health Organization recommends standardised treatment durations for patients with tuberculosis (TB). We identified and validated a host-RNA signature as a biomarker for individualised therapy durations for patients with drug-susceptible (DS)- and multidrug-resistant (MDR)-TB.MethodsAdult patients with pulmonary TB were prospectively enrolled into five independent cohorts in Germany and Romania. Clinical and microbiological data and whole blood for RNA transcriptomic analysis were collected at pre-defined time points throughout therapy. Treatment outcomes were ascertained by TBnet criteria (6-month culture status/1-year follow-up). A whole-blood RNA therapy-end model was developed in a multistep process involving a machine-learning algorithm to identify hypothetical individual end-of-treatment time points.Results50 patients with DS-TB and 30 patients with MDR-TB were recruited in the German identification cohorts (DS-GIC and MDR-GIC, respectively); 28 patients with DS-TB and 32 patients with MDR-TB in the German validation cohorts (DS-GVC and MDR-GVC, respectively); and 52 patients with MDR-TB in the Romanian validation cohort (MDR-RVC). A 22-gene RNA model (TB22) that defined cure-associated end-of-therapy time points was derived from the DS- and MDR-GIC data. The TB22 model was superior to other published signatures to accurately predict clinical outcomes for patients in the DS-GVC (area under the curve 0.94, 95% CI 0.9–0.98) and suggests that cure may be achieved with shorter treatment durations for TB patients in the MDR-GIC (mean reduction 218.0 days, 34.2%; p<0.001), the MDR-GVC (mean reduction 211.0 days, 32.9%; p<0.001) and the MDR-RVC (mean reduction of 161.0 days, 23.4%; p=0.001).ConclusionBiomarker-guided management may substantially shorten the duration of therapy for many patients with MDR-TB.
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Ainiyah, Safira Nur, Soedarsono Soedarsono, and Pirlina Umiastuti. "The Relationship between Family’s Assessment Support and MDR TB Patient’s Adherence on Treatment in RSUD Dr. Soetomo Surabaya." JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga 10, no. 2 (August 30, 2019): 75. http://dx.doi.org/10.20473/juxta.v10i22019.75-78.
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Introduction: Multi Drug-Resistant Tuberculosis (MDR TB) is caused by Mycobacterium tuberculosis and has been resistant to isoniazid and rifampicin. Its treatment needs long time and causes some side effects which can make the patients non-adherent so that family support is needed. This study aims to know the relationship between family’s assessment support and MDR TB patient’s adherence on treatment in RSUD Dr. Soetomo Surabaya. Methods: This was an analytic observational cross-sectional study, to know the frequency distribution of family’s assessment support, MDR TB patient’s adherence, and the relationship between them in 24 MDR TB patients, recruited from MDR TB Clinic, RSUD Dr. Soetomo, Surabaya, from October 2017 to June 2018 and their family. The analysis was descriptive statistic and inferential statistic using Fisher Exact Test. Results: The results of this study showed that 83.3% of MDR TB patients’ family give high assessment support and 58.3% of MDR TB patients in RSUD Dr. Soetomo from October 2017 to June 2018 have high adherence on treatment. There is significant (p = 0.020), moderate (c = 0.468), and direct relationship between family’s assessment support and MDR TB patient’s adherence on treatment in RSUD Dr. Soetomo Surabaya. Conclusion: To improve MDR TB patient’s adherence on treatment, family must give high assessment support.
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Basingnaa, Anthony, Samuel Antwi-Baffour, Dinah Nkansah, Emmanuel Afutu, and Enid Owusu. "Plasma Levels of Cytokines (IL-10, IFN-γ and TNF-α) in Multidrug Resistant Tuberculosis and Drug Responsive Tuberculosis Patients in Ghana." Diseases 7, no. 1 (December 23, 2018): 2. http://dx.doi.org/10.3390/diseases7010002.
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The emergence of multidrug-resistant tuberculosis (MDR–TB) and more recently, extensively drug-resistant (XDR) TB has intensified the need for studies aimed at identifying factors associated with TB drug resistance. This study determined the differences in plasma concentrations of pro-inflammatory (IFN-γ and TNF-α) and anti-inflammatory (IL-10) cytokines in MDR-TB and drug-susceptible (DS) TB patients, in addition to some socio-economic factors. Plasma levels of IL-10, IFN-γ and TNF-α were measured in 83 participants (comprising 49 MDR-TB and 34 DS-TB patients) using sandwich ELISA. Levels of the three cytokines were elevated in MDR-TB patients compared to DS-TB patients. The mean level of IL-10 (7.8 ± 3.61 ρg/mL) measured in MDR-TB cases was relatively higher than those of TNF-α and IFN-γ, and statistically significant (p = 0.0022) when compared to the level of IL-10 (4.8 ± 4.94 ρg/mL) in the DS-TB cases. There were statistically significant associations between MDR-TB and factors such as education level (X2 = 9.895, p = 0.043), employment status (X2 = 19.404, p = 0.001) and alcoholism (X2 = 3.971, p = 0.046). This study adds to the knowledge that IFN-γ, TNF-α and IL-10 play a role in the host response to Mycobacterium tuberculosis (MTB). Alcohol intake can be considered as an important MDR-TB risk factor.
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Lv, Xin-Tong, Xi-Wei Lu, Xiao-Yan Shi, and Ling Zhou. "Prevalence and risk factors of multi-drug resistant tuberculosis in Dalian, China." Journal of International Medical Research 45, no. 6 (March 27, 2017): 1779–86. http://dx.doi.org/10.1177/0300060516687429.
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Objectives To investigate the prevalence and risk factors associated with multi-drug resistant tuberculosis (MDR–TB) in Dalian, China. Methods This was a retrospective review of data from patients attending a TB clinic in Dalian, China between 2012 and 2015. Demographic and drug susceptibility data were retrieved from TB treatment cards. Univariate logistic analysis was used to assess the association between risk factors and MDR–TB. Results Among the 3552 patients who were smear positive for Mycobacterium tuberculosis (MTB), 2918 (82.2%) had positive MTB cultures and 1106 (31.1%) had isolates that showed resistance to at least one drug. The overall prevalence of MDR–TB was 10.1% (359/3552; 131/2261 [5.8%] newly diagnosed and 228/1291 [17.7%] previously treated patients). Importantly, 75 extensively drug-resistant TB isolates were detected from 25 newly treated and 50 previously treated patients. In total, 215 (6.1%) patients were infected with a poly-resistant strain of MTB. Previously treated patients and older patients were more likely to develop MDR–TB. Conclusions The study showed a high prevalence of MDR–TB among the study population. History of previous TB treatment and older age were associated with MDR–TB.
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Gobaud, A. N., C. A. Haley, J. W. Wilson, R. Bhavaraju, A. Lardizabal, B. J. Seaworth, and N. D. Goswami. "Multidrug-resistant tuberculosis care in the United States." International Journal of Tuberculosis and Lung Disease 24, no. 4 (April 1, 2020): 409–13. http://dx.doi.org/10.5588/ijtld.19.0515.
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BACKGROUND: To examine the utilization of the Tuberculosis (TB) Centers of Excellence (COE) medical consultation service and evaluate how these services were being employed for patients in relation to multidrug-resistant TB (MDR-TB).METHODS: Medical consults are documented in a secure database. The database was queried for MDR-TB consultations over the period 1 January 2013–31 December 2017. All were analyzed to assess provider type, center, setting, year of call, and type of patient (pediatric vs. adult). A subgroup was randomly selected for thematic analysis.RESULTS: The centers received 1560 MDR-TB consultation requests over this period. Providers requesting consults were primarily physicians (55%). The majority of requests were from public health departments (64%) and for adult patients (80%). Four major topic areas emerged: 1) initial management of MDR-TB, 2) MDR-TB longitudinal treatment and complications, 3) management of persons exposed to MDR-TB, and 4) MDR-TB treatment completion.CONCLUSIONS: Analysis of these consultations provides insight into the type of expert advice about MDR-TB that was provided. These findings highlight topics where increased medical training and education may help to improve MDR-TB-related practices.
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Wicaksono, Bagus. "Monocyte Lymphocyte Ratio, Platelet Lymphocyte Ratio, Neutrophil Lymphocyte Ratio as Prognostic Markers in Patients with Multidrugs Resistant Tuberculosis Treated at Ulin General Hospital Banjarmasin." Berkala Kedokteran 14, no. 2 (September 17, 2018): 165. http://dx.doi.org/10.20527/jbk.v14i2.5330.
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Abstract: Multi Drugs Resistant Tuberculosis (MDR TB) is tubercolusis with the least resistance to rifampicin and isoniazid. The progresivity and side effects of MDR TB treatment can be monitored through clinical, imaging, and laboratory evaluation. Monocyte Lymphocyte Ratio (MLR), Neutrophil Lymphocyte Ratio (NLR), and Platelet Lymphocyte Ratio (PLR) are the inflammatory markers used as biomarkers of treatment progress in MDR TB. The purpose of this research was to determine the difference of MLR, NLR, and PLR value pre and post MDR TB therapy and to determine the best prognostic biomarker in the evaluation of MDR TB treatment progress at Ulin General Hospital in January-December 2017. This research was an analytic observational study with a cross-sectional design. The sample was 17 patients selected based on the inclusion and exclusion criteria. Results obtained from paired T-tests showed the decreasing of MLR, NLR, PLR value in MDR TB patients receiving TB therapy. PLR had a more role as inflammatory biomarker of MDR TB treatment with p = 0.000, compared to MLR (ρ = 0.01), and NLR ( ρ = 0.006). The conclusion is PLR was significantly the best prognostic biomarker for MDR TB treatment. Keywords: MDR TB, Monocyte Lymphocyte Ratio, Neutrophil Lymphocyte Ratio, Platelet Lymphocyte Ratio
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Wahyudhi, Andri Kurnia, Retno Asih Setyoningrum, and Ahmad Suryawan. "Long term follow-up of multidrug resistant tuberculosis in a pubertal child." Paediatrica Indonesiana 58, no. 4 (August 30, 2018): 198–204. http://dx.doi.org/10.14238/pi58.4.2018.198-204.
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Increasing awareness of the rising global rates of multidrug-resistant tuberculosis (MDR-TB) has led to a concerted international effort to confront this disease. Nonetheless, despite cure rates >80% in some programs, MDR-TB patients tend to have chronic disease and require prolonged therapy.1-3 Little is known about the long-term results and follow-up of patients with MDR-TB, include the recurrence rate and chronic disability in patients who have recovered from TB.4
There are many side effects and adverse reactions to drugs can occur during MDR-TB treatment. These could be physical and or psychological, as well as reversible or irreversible. Treatment of MDR-TB requires a combination regimen, consists of second and third-line anti-tuberculosis drugs which more toxic than first-line drugs. Additionally, MDR-TB treatment requires a long duration of treatment (18-24 months) and causes discomfort in the patient.5 In a cohort of 60 patients treated for MDR-TB, the most common side effects included gastritis (100%), dermatological disorders (43%), and peripheral neuropathy (16.7).6 While in a cohort of 75 patients, the incidence of depression, anxiety, and psychosis for MDR-TB treatments was 13.3%, 12.0%, and 12.0%, respectively.7
Aggressive and effective management are needed so the patient can tolerate the treatment and remain adhere the treatment.8 Long-term follow-up is required for the rehabilitation of disorders due to psychosocial sequelae. As such, psychosocial support can be benefit pediatric MDR-TB patients.
Here, we present a case report on a two-year follow-up of a pubertal child with MDR-TB, focusing on medical aspects and her development.
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Damayanti, Meisika, and Surati Surati. "Profile of SGPT Levels in Multidrug Resistant Tuberculosis Patients (MDR-TB)." Jaringan Laboratorium Medis 2, no. 2 (September 22, 2021): 68–74. http://dx.doi.org/10.31983/jlm.v2i2.7687.
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Multidrug Resistant Tuberculosis (MDR-TB) has recently become a health threat in Indonesia. The clinical management of MDR TB is more complicated than that of ordinary TB. Hepatotoxicity or commonly known as Anti-Tuberculosis Drug-induced Hepatotoxicity (ATDH) is a serious effect of OAT that often occurs. The basic parameter for diagnosing or following up the presence of impaired liver function is the SGPT examination. The purpose of this study was to describe the level of SGPT in MDR-TB patients at the Kendal District Health Center. This study is an observational (non-experimental) study with descriptive research criteria with a cross sectional approach which was conducted on 7 MDR-TB patients at Kendal I Health Center, Kaliwungu Health Center, and South Kaliwungu Health Center with total sampling technique. The results of the study: obtained SGPT levels in 7 patients with MDR-TB there were 7 research respondents (100%) had normal SGPT levels with the lowest level of 2.17 U/L and the highest level of 37.75 U/L and the average level of SGPT ie 18.01 U/L. TB mostly attacks the age group of 56-65 years (57%). Males (57%) were the patients with the most TB cases. The most OAT consumption time was in the continuation phase (100%). Diabetes is a disease that often accompanies TB patients. The conclusion of this study is that from 7 research subjects, MDR-TB patients had SGPT levels that were in the normal range.
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Hersi, Ahmed, Kevin Elwood, Robert Cowie, Dennis Kunimoto, and Richard Long. "Multidrug-Resistant Tuberculosis in Alberta and British Columbia, 1989 to 1998." Canadian Respiratory Journal 6, no. 2 (1999): 155–60. http://dx.doi.org/10.1155/1999/456395.
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OBJECTIVE: To describe the extent of the problem of multidrug-resistant tuberculosis (MDR-TB) in Alberta and British Columbia from 1989 to 1998.DESIGN: A retrospective, population-based descriptive study of all notified MDR-TB cases in the context of all notified TB cases, all notified culture-positive TB cases and all notified drug-resistant TB cases.SETTING: Provinces of Alberta and British Columbia, and their TB registries.PATIENTS: All people with TB reported to the TB registries of Alberta and British Columbia between January 1, 1989 and June 30, 1998.MAIN OUTCOME MEASURES: Drug susceptibility testing was performed in all cases of culture-positive TB. Demographic, clinical and laboratory data on all cases of MDR-TB were recorded.RESULTS: Of 4606 notified cases of TB, 3553 (77.1%) were culture positive. Of these, 365 (10.3%) were drug resistant; of the drug-resistant cases, 24 (6.6%) were MDR. Most MDR-TB patients were foreign-born; of the four Canadian-born patients, two were infected while travelling abroad. Although foreign-born patients were significantly more likely to harbour drug-resistant strains, 14.3% versus 4.8%, respectively (P<0.001), among those who were harbouring a drug-resistant strain, the proportion of Canadian-born versus foreign-born patients with an MDR strain was the same (6.7% versus 6.6%, respectively). From 1994 to 1998 versus 1989 to 1993, the proportion of all drug-resistant strains that were MDR was greater (9.0% versus 4.3%, respectively), but the difference was not statistically significant. Isolates from 16 of the 24 MDR-TB cases had been archived. Each of these was fingerprinted and found to be unique. Most MDR-TB cases (88%) were respiratory. Of those tested for human immunodeficiency virus (n=17), only one was seropositive. MDR-TB was ‘acquired’ in 67% and ‘primary’ in 33% of cases. Eight (33%) of the MDR-TB cases received curative courses of treatment, six (25%) are still being treated, and the remainder have either died (five, 21%), transferred out (four, 17%) or become ‘chronic’ (one, 4%). No secondary case of MDR-TB has been identified in Alberta and British Columbia.CONCLUSIONS: Most MDR-TB in Alberta and British Columbia is imported. The proportion of all drug-resistant cases that are MDR appears to be increasing, but not because of disease acquired from recent contact with MDR-TB in Canada.
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Nugrahaeni, Dyan Kunthi, and Salma Zaqiya. "The Relationship between Previous Tuberculosis Treatment and HIV Status with Multidrug-Resistant Tuberculosis." Jurnal Kesehatan Masyarakat 14, no. 3 (May 21, 2019): 347–52. http://dx.doi.org/10.15294/kemas.v14i3.14087.
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Multidrug-resistant tuberculosis (MDR-TB) is becoming major public health issues in the world. Among the causes are history of previous TB treatment and increased co-infection of TB-HIV (Human Immunodeficiency Virus). This study aimed to identify the relationship between history of previous TB treatment and HIV status with MDR-TB. This is a case control study. The sample case was patients with MDR-TB, while sample control was patient who have drug-sensitive TB. Secondary data was obtained from patient medical records and laboratory results at Rotinsulu Pulmonary Hospital Bandung. Data were analyzed using chi-square. Multiple logistic regression was used to identify the dominant factor that influence the occurrence of MDR-TB. This study showed that the history of previous TB treatment was statistically significant with MDR-TB (p value= 0.001; OR= 18.889; 95% CI= 4.093-87.172) and it is the dominant factor that influence MDR-TB (p value= 0.0001; OR= 56.84; 95% CI= 6.9- 468.87). HIV infection at control group (who contracted drug-sensitive TB) was 26.1% (p value= 0.022). This finding suggested that HIV testing should be performed to each TB and MDR-TB patients and increased collaboration TB-HIV program between the other health care facilities should ensue. Drug sensitivity testing should be conducted at the start of TB treatment for patients with previous TB treatment and TB-HIV co-infection.
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Dorji, Thinley. "Epidemiology of Drug Resistant Tuberculosis in Samtse General Hospital, Bhutan: A Retrospective Study." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 17, no. 1 (July 26, 2019): 41–46. http://dx.doi.org/10.3126/saarctb.v17i1.25027.
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Introduction: Multidrug resistant tuberculosis (MDR-TB) is defined as a case of tuberculosis resistant to rifampicin and isoniazid which are the first line anti tuberculosis drugs. Globally emergences of MDR-TB possess a challenge to TB control. In Bhutan, the proportion of MDR-TB is high at par with the global level. This study will explore the predictors of MDR-TB and the trend at Samtse General Hospital which has high burden of tuberculosis.
Methods: This was a retrospective cross sectional study. The data was extracted from TB treatment cards maintained at TB unit of Samtse General Hospital TB from January 2012 to June 2018.
Results: The study showed the prevalence of drug resistant to at least one drug at 21% and MDR-TB prevalence at 16%. The patients with previous treatments (AOR: 4.59; 95% CI .03-.18) and patients under the age of 30 years (AOR: 2.7; 95% CI 1.01- 7.42) were significantly associated with MDR-TB.
Conclusion: This study shows high prevalence of MDR-TB in Samtse. Better strategies and concrete actions need to be developed to combat the increase of MDR-TB.
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Mehari, Kibriti, Tsehaye Asmelash, Haftamu Hailekiros, Tewolde Wubayehu, Hagos Godefay, Tadele Araya, and Muthupandian Saravanan. "Prevalence and Factors Associated with Multidrug-Resistant Tuberculosis (MDR-TB) among Presumptive MDR-TB Patients in Tigray Region, Northern Ethiopia." Canadian Journal of Infectious Diseases and Medical Microbiology 2019 (September 9, 2019): 1–8. http://dx.doi.org/10.1155/2019/2923549.
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Background. Tuberculosis (TB) is one of the major public health problems. There are alarming reports of increasing multidrug-resistant tuberculosis (MTR-TB) from various parts of the globe, including Ethiopia. This study was designed to determine the prevalence and factors associated with MDR-TB among presumptive MDR-TB cases in Tigray Regional State, Ethiopia. Methods. A cross-sectional study was conducted in Tigray Regional State from 2015 to 2016. Two hundred sputum samples were collected, transported, processed using 2% N-acetyl-L-cysteine-sodium hydroxide, and cultured in LJ medium. Besides, the microscopic examination was performed after ZN staining. Moreover, drug susceptibility test was done using molecular line probe assay. Descriptive statistics and binary and multivariable logistic regression were done. A statistical test was regarded as significant when the P value was <0.05. Results. The prevalence of MDR-TB was found to be 18.5%. About one-fourth (26.5%) of the study participants had sputum smear positive for acid-fast bacilli (AFB). TB culture was positive in 37% of the samples, and rifampicin mono-resistant cases accounted for 3.5% of the presumptive MDR-TB cases. Three (1.5%) were new MDR-TB cases, while the rest had been treated previously for TB. Most (63.5%) of the MDR-TB cases were from 15 to 44 years of age. Age was associated with MDR-TB with a crude odds ratio of 1.06 (CI: 1.02–1.10) and adjusted odds ratio of 1.06 (CI: 1.00–1.11). Conclusions. The prevalence of MDR-TB was found to be high. Preventive measures should be taken to prevent the transmission of MDR-TB in the community.
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Singh, Anjana, Ved Prakash, and Ravi Kant. "Epidemiological Correlates and Treatment Outcomes among Patients with MDR Tuberculosis in Northern India." Annals of the National Academy of Medical Sciences (India) 54, no. 02 (April 2018): 090–95. http://dx.doi.org/10.1055/s-0040-1712791.
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ABSTRACT Introduction: Multi drug resistant-TB (MDR-TB) threatens global TB control and is a major public health concern in several countries. The present study was undertaken to detect the epidemiological correlates and treatment outcomes among patients with MDR-TB previously or currently admitted in Department of Respiratory Medicine and Pulmonary and Critical Medicine, KGMU, Lucknow. Material & Methods: This retrospective study included 2370 TB patients admitted in the Department of Respiratory Medicine and Pulmonary and Critical Medicine, KGMU, Lucknow between years 2012 to 2015. Treatment outcomes were observed. SPSS software was used for data analysis. Results: The total number of MDR-TB cases enrolled were 2370. There were 772 (32.6%) males (95% CI: 30.7 % -34.5%) and 1598 (67.4%) females (95% CI: 65.5% -69.3%) registered for MDR-TB treatment. The treatment outcomes were as follows: majority (77.1%) were under treatment, 279 (11.8%) patients were declared cured, 10 (0.4%) were failure cases, while 64 (2.7%) were defaulters, 149 (6.3%) had died and 41(1.7%) were transferred out. Conclusion: Emergence of MDR-TB has the potential to be a serious public health problem in Northern India and this necessitates strengthening of TB control and improved continuous monitoring of therapy.
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Ali, Monadil H., Alian A. Alrasheedy, Mohamed Azmi Hassali, Dan Kibuule, and Brian Godman. "Predictors of Multidrug-Resistant Tuberculosis (MDR-TB) in Sudan." Antibiotics 8, no. 3 (July 9, 2019): 90. http://dx.doi.org/10.3390/antibiotics8030090.
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Multidrug-resistant tuberculosis (MDR-TB) is a global public health threat and burden on the health system. This is especially the case in high tuberculosis (TB) prevalence countries, such as Sudan. Consequently, this study aimed to ascertain the predictors of MDR-TB in Sudan to provide future guidance. An unmatched case-control study to assess the predictors of MDR-TB infections among the Sudanese population was conducted from August 2017 to January 2018 at Abu-Anga referral hospital. Patients’ data was gathered from patients’ cards and via interviews. A structured pre-validated questionnaire was used to gather pertinent information, which included sociodemographic characteristics and other relevant clinical data. Univariate and multivariate logistic regression analysis was employed to determine the predictors of MDR-TB infection. 76 of the 183 patients interviewed (41.5%) had MDR-TB cases. The independent predictors for MDR-TB were living in rural areas [adjusted odds ratio (aOR) = 3.1 (95% confidence interval (CI): 1.2–8.2)], treatment failure [aOR = 56.9 (10.2–319.2)], and smoking [(aOR = 4 (1.2–13.2)], whereas other sociodemographic factors did not predict MDR-TB. In conclusion, the study showed that a history of smoking, living in rural areas, and a previous treatment failure were the predictors of MDR-TB in Sudan. The latter factors are most likely due to issues that are related to access and adherence to treatment and lifestyle. The existence of any of these factors among newly diagnosed TB patients should alert clinicians for the screening of MDR-TB. The implementation of directly observed treatment (DOT) and health education are crucial in stopping the spread of MDR-TB in Sudan.
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Awasthi, Sadhana, Neha Verma, Ram Gopal Nautiyal, and Hariom Kumar Solanki. "Profile of Multi Drug Resistant Tuberculosis patients: A Study at Drug Resistant Tuberculosis Centre in Kumaun Region, Uttarakhand." Indian Journal of Community Health 32, no. 4 (December 31, 2020): 647–52. http://dx.doi.org/10.47203/ijch.2020.v32i04.007.
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Background: Drug Resistant Tuberculosis (DR-TB) has frequently been encountered in India, and its presence has been known virtually from the time anti-TB drugs were introduced for the treatment of Tuberculosis. Multi Drug Resistant Tuberculosis (MDR-TB) is a man-made phenomenon and has become a formidable challenge to effective Tuberculosis control in India. Objectives: To study the Socio-demographic and Clinical profile of Multi Drug Resistant Tuberculosis (MDR-TB) patients presenting to Drug Resistant Tuberculosis (DR-TB) Centre at Govt. Medical College, Haldwani in the Kumaun region, Uttarakhand. Methodology: This study is a Record based study, where in service data available at Drug Resistant Tuberculosis (DR-TB) Centre at Govt. Medical College, Haldwani in the Kumaun region, Uttarakhand, was accessed and analyzed. Inclusion criteria included all patients with diagnosis of Multi Drug Resistant Tuberculosis (MDR-TB) presenting to the centre from 1st April 2015 to 31st December 2015. Results: The present study showed that younger age group particularly males were more affected with MDR-TB. Under-nutrition was quite prevalent among the MDR-TB patients. 56.7% cases were addicted to alcohol and 54.3% cases were addicted to smoking. 85.8% patients took treatment for TB and 44.1% not completed their treatment. Relapse of previous anti-tuberculosis treatment was found to be the major contributor in MDR-TB suspect cases. Prevalence of XDR-TB was also found to be low. Conclusion: The findings of the study emphasize the importance of studying the socio-demographic factors and baseline clinical characteristics in different MDR-TB patient categories to timely modify and strengthen the national programs.
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Anggana, Renditya, and Filia Sofia Ikasari. "Telenursing Development of N-SMSI (Short Message Service Intervention) in the care of post-treatment TB patients in hospitals." Jurnal Ilmiah Keperawatan Indonesia [JIKI] 3, no. 1 (May 23, 2020): 10. http://dx.doi.org/10.31000/jiki.v3i1.2058.
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Tuberculosis (TB) is still a deadly infectious disease in the community. TB patient’s compliance in the consumption of Anti-TB drugs for 6 months, determine the recovery of TB patients. The outpatients TB is most likely to experience a drug dropout which can lead to Multi Drug Resistance Tuberculosis (MDR-TB), so that Supervisors Take Medication are needed to prevent the occurrence of MDR-TB. Ners-Short Message Service Intervention (N-SMSI) is one of the information systems that can developed to prevent the occurrence of MDR-TB. The purpose of writing this article is to describe and analyze the development of N-SMSI telenursing as an information system for conducting observations in the care of TB patients who can help TB patients achieve recovery in a way that effective and efficient. The method in writing this article is the study of literature using a variety of literature related to the application of N-SMSI especially in the prevention of MDR-TB. The results of the literature study show that N-SMSI can be utilized in monitoring patient compliance in consuming OAT, so that expectations cured patients is very large and the mortality rate in TB cases can be suppressed as much as possible. This literature recommends the application of N-SMSI in outpatient TB patients to facilitate activities monitoring by health workers in the prevention of MDR-TB.Keywords: MDR-TB, N-SMS, Telenursing, Tuberculosis
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Puerto Castro, Gloria Mercedes, Fernando Nicolás Montes Zuluaga, Jacqueline Elizabeth Alcalde-Rabanal, and Freddy Pérez. "Patient- and provider-related factors in the success of multidrug-resistant tuberculosis treatment in Colombia." Revista Panamericana de Salud Pública 45 (June 21, 2021): 1. http://dx.doi.org/10.26633/rpsp.2021.74.
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Objective. To identify patient- and provider-related factors associated with the success of multidrug-resistant tuberculosis (MDR-TB) treatment in the six municipalities of Colombia with the highest number of MDR-TB cases. Methods. Bivariate and multivariate logistic regressions were used to analyze the association between treatment success (cure or treatment completion) and characteristics of the patients and physicians, nursing professionals, and psychologists involved in their treatment. The importance of knowledge in the management of MDR-TB cases was explored through focus groups with these providers. Results. Of 128 cases of TB-MDR, 63 (49.2%) experienced treatment success. Only 52.9% of the physicians and nursing professionals had satisfactory knowledge about MDR-TB. Logistic regression showed that being HIV negative, being affiliated with the contributory health insurance scheme, being cared for by a male physician, and being cared for by nursing professionals with sufficient knowledge were associated with a successful treatment outcome (p ≤ 0.05). Qualitative analysis showed the need for in-depth, systematic training of health personnel who care for patients with MDR-TB. Conclusion. Some characteristics of patients and healthcare providers influence treatment success in MDR-TB cases. Physicians’ and nurses’ knowledge about MDR-TB must be improved, and follow-up of MDR-TB patients who are living with HIV and of those affiliated with the subsidized health insurance scheme in Colombia must be strengthened, as these patients have a lower likelihood of a successful treatment outcome.
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Batte, Charles, Martha S. Namusobya, Racheal Kirabo, John Mukisa, Susan Adakun, and Achilles Katamba. "Prevalence and factors associated with non-adherence to multi-drug resistant tuberculosis (MDR-TB) treatment at Mulago National Referral Hospital, Kampala, Uganda." African Health Sciences 21, no. 1 (April 16, 2021): 238–47. http://dx.doi.org/10.4314/ahs.v21i1.31.
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Background: In Uganda, 12% of previously treated TB cases and 1.6% of new cases have MDR-TB and require specialized treatment and care. Adherence is crucial for improving MDR-TB treatment outcomes. There is paucity of information on the extent to which these patients adhere to treatment and what the drivers of non-adherence are.
Methods: We conducted a cohort study using retrospectively collected routine program data for patients treated for MDR- TB between January 2012 – May 2016 at Mulago Hospital. We extracted anonymized data on non-adherence (missing 10% or more of DOT), socio-economic, demographic, and treatment characteristics of the patients. All participants were sen- sitive to MDR-TB drugs after second line Drug Susceptible Testing (DST) at entry into the study. Factors associated with non-adherence to MDR-TB treatment were determined using generalized linear models for the binomial family with log link and robust standard errors. We considered a p- value less than 0.05 as statistically significant.
Results: The records of 227 MDR- TB patients met the inclusion criteria, 39.4% of whom were female, 32.6% aged be- tween 25 – 34 years, and 54.6% living with HIV/AIDS. About 11.9% of the patients were non-adherent. The main driver for non-adherence was history of previous DR-TB treatment; previously treated DR-TB patients were 3.46 (Adjusted prev- alence ratio: 3.46, 95 % CI: 1.68 - 7.14) times more likely to be non-adherent.
Conclusion: One in 10 MDR-TB patients treated at Mulago hospital is non-adherent to treatment. History of previous DR- TB treatment was significantly associated with non-adherence in this study. MDR-TB program should strengthen adherence counselling, strengthen DST surveillance, and close monitoring for previously treated DR-TB patients.
Keywords: Non-adherence; multi-drug resistant tuberculosis; treatment.